title: Does continuous endurance exercise in water elicit a higher release of ANP and BNP and a higher plasma concentration of FFAs in pre-obese and obese men than high intensity intermittent endurance exercise? - study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Atrial natriuretic peptides (ANP) and Brain natriuretic peptides (BNP) stimulate fat cell plasma membrane receptors. They are potent lipolytic agents on isolated fat cells from subcutaneous adipose tissue. The physiological effects of continuous endurance exercise on ANP release and plasma free fatty acids (FFA) concentrations have been well described. The enhancement of fat metabolism using high intensity intermittent exercise protocols has been assessed in more recent investigations. The combined effects of endurance exercise and water immersion on ANP and FFA plasma concentration and the magnitude of excess post-exercise oxygen consumption (EPOC) might be further enhanced by choosing the most effective exercise protocol. Exercise modalities may play a significant role in the future prevention and treatment of obesity.
  
  
  METHODS
  The two testing trials will be performed according to a randomized and cross-over design. Twenty healthy sedentary pre-obese and obese class-1 men will be scrutinized with regard to their metabolic responses to continuous exercise in water and to high intensity endurance exercise in water. Both trials will be matched for energy expenditure. After preliminary testing, the tests will be conducted as repeated measurements. The two different exercise protocols will be compared. The aims of the study are to investigate (1) whether continuous endurance exercise or high intensity intermittent endurance exercise in water elicits both a higher release of ANP and BNP and a higher plasma concentration of glycerol and (2) to determine whether continuous endurance exercise in water or a high intensity intermittent endurance exercise in water would lead to a more pronounced short term (two hours) EPOC effect.
  
  
  CONCLUSIONS
  If our hypothesis would be confirmed, the most effective exercise protocol based on the combined effects of high intensity endurance exercise and water immersion on ANP and BNP release and glycerol plasma concentrations can be identified. Moreover, the magnitude of the EPOC effect can be augmented. Our study would provide a major contribution for creating optimized exercise modalities in the prevention and treatment of obesity.
  
  
  BACKGROUND
  Current controlled trials, ISRCTN95488515.
authors.affiliation: Institute of General Practice and for Health Services Research, University of Zurich, Zurich, Switzerland. beat.knechtle@hispeed.ch.
authors.forename: Klaus
authors.initials: K
authors.lastname: Karner-Rezek
authors.forename: Beat
authors.initials: B
authors.lastname: Knechtle
authors.forename: Matthias
authors.initials: M
authors.lastname: Fenzl
authors.forename: Joeri
authors.initials: J
authors.lastname: Gredig
authors.forename: Thomas
authors.initials: T
authors.lastname: Rosemann
mesh_terms: D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D018592:Cross-Over Studies; D005081:Exercise Therapy / Q000379:methods*; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005990:Glycerol / Q000097:blood; D006801:Humans; D006875:Hydrotherapy; D007101:Immersion; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009765:Obesity / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010807:Physical Endurance; D012107:Research Design; D057185:Sedentary Behavior; D013557:Switzerland; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation; D014867:Water
chemical_list: D015415:Biomarkers; D005230:Fatty Acids, Nonesterified; D014867:Water; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor; D005990:Glycerol